HESI MATERNITY OB
COMPREHENSIVE REVIEW QUESTIONS
AND CORRECT ANSWERS
1. A client at 32 weeks gestation is admitted with a diagnosis of severe preeclampsia. Which
assessment finding should the nurse report to the healthcare provider immediately?
A. 1+ pitting edema in the lower extremities
B. Urine output of 20 mL/hr
C. Blood pressure of 148/92 mmHg
D. Fetal heart rate of 140 beats per minute
Answer: B
Conceptual Explanation: In severe preeclampsia, a urine output of less than 30 mL/hr
indicates decreased renal perfusion and potential renal failure, which requires immediate
intervention.
2. A nurse is caring for a client in the first stage of labor. The fetal heart rate (FHR) monitor
shows repetitive late decelerations. What is the priority nursing action?
A. Perform a vaginal exam to check for cord prolapse
B. Document the findings and continue to monitor
C. Increase the rate of the oxytocin infusion
,D. Turn the client to the left side and apply oxygen via face mask
Answer: D
Conceptual Explanation: Late decelerations are caused by uteroplacental insufficiency.
The priority is to improve oxygenation to the fetus by repositioning the mother and
providing oxygen.
3. A client is 4 hours postpartum and the nurse notes that the fundus is firm, midline, and two
fingerbreadths below the umbilicus. However, the client is experiencing steady, bright red
bleeding. What is the most likely cause?
A. Uterine atony
B. Retained placental fragments
C. Normal lochia rubra
D. Cervical or vaginal laceration
Answer: D
Conceptual Explanation: If the fundus is firm but there is still steady bleeding, a
laceration of the birth canal is the most likely cause. Uterine atony would result in a boggy
fundus.
4. A nurse is teaching a pregnant client about the importance of folic acid. Which condition
does folic acid help prevent?
A. Gestational diabetes
, B. Neural tube defects
C. Preeclampsia
D. Fetal macrosomia
Answer: B
Conceptual Explanation: Folic acid intake during the periconceptual period and early
pregnancy is critical for the proper closure of the neural tube, preventing defects like spina
bifida.
5. The nurse is assessing a newborn 1 minute after birth. The heart rate is 110 bpm, the cry is
vigorous, there is some flexion of the extremities, the newborn sneezes when suctioned, and
the body is pink with blue extremities. What is the Apgar score?
A. 8
B. 7
C. 9
D. 10
Answer: A
Conceptual Explanation: Heart rate (>100) = 2; Cry/Respiration (Vigorous) = 2;
Flexion/Muscle tone (Some) = 1; Reflex irritability (Sneeze) = 2; Color (Acrocyanosis) = 1.
Total = 8.
COMPREHENSIVE REVIEW QUESTIONS
AND CORRECT ANSWERS
1. A client at 32 weeks gestation is admitted with a diagnosis of severe preeclampsia. Which
assessment finding should the nurse report to the healthcare provider immediately?
A. 1+ pitting edema in the lower extremities
B. Urine output of 20 mL/hr
C. Blood pressure of 148/92 mmHg
D. Fetal heart rate of 140 beats per minute
Answer: B
Conceptual Explanation: In severe preeclampsia, a urine output of less than 30 mL/hr
indicates decreased renal perfusion and potential renal failure, which requires immediate
intervention.
2. A nurse is caring for a client in the first stage of labor. The fetal heart rate (FHR) monitor
shows repetitive late decelerations. What is the priority nursing action?
A. Perform a vaginal exam to check for cord prolapse
B. Document the findings and continue to monitor
C. Increase the rate of the oxytocin infusion
,D. Turn the client to the left side and apply oxygen via face mask
Answer: D
Conceptual Explanation: Late decelerations are caused by uteroplacental insufficiency.
The priority is to improve oxygenation to the fetus by repositioning the mother and
providing oxygen.
3. A client is 4 hours postpartum and the nurse notes that the fundus is firm, midline, and two
fingerbreadths below the umbilicus. However, the client is experiencing steady, bright red
bleeding. What is the most likely cause?
A. Uterine atony
B. Retained placental fragments
C. Normal lochia rubra
D. Cervical or vaginal laceration
Answer: D
Conceptual Explanation: If the fundus is firm but there is still steady bleeding, a
laceration of the birth canal is the most likely cause. Uterine atony would result in a boggy
fundus.
4. A nurse is teaching a pregnant client about the importance of folic acid. Which condition
does folic acid help prevent?
A. Gestational diabetes
, B. Neural tube defects
C. Preeclampsia
D. Fetal macrosomia
Answer: B
Conceptual Explanation: Folic acid intake during the periconceptual period and early
pregnancy is critical for the proper closure of the neural tube, preventing defects like spina
bifida.
5. The nurse is assessing a newborn 1 minute after birth. The heart rate is 110 bpm, the cry is
vigorous, there is some flexion of the extremities, the newborn sneezes when suctioned, and
the body is pink with blue extremities. What is the Apgar score?
A. 8
B. 7
C. 9
D. 10
Answer: A
Conceptual Explanation: Heart rate (>100) = 2; Cry/Respiration (Vigorous) = 2;
Flexion/Muscle tone (Some) = 1; Reflex irritability (Sneeze) = 2; Color (Acrocyanosis) = 1.
Total = 8.
